11-1 |
Providing notifications to employees and employers
|
1/1/2023
1/1/2021
1/1/2020
1/1/2019
1/1/2018
6/1/2010
|
11-3 |
Correcting employing agency enrollment errors
|
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
1/1/2014
|
15-1 |
Determining eligibility for seasonal employees and maintenance of employer contribution through the off-season |
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
1/1/2011
|
17-1 |
Determining faculty eligibility for summer/short class sessions |
1/1/2022
1/1/2020
1/1/2018
1/1/2017
1/1/2010
|
17-2 |
Determining faculty eligibility after a layoff |
1/1/2023
1/1/2021
1/1/2019
1/1/2018
1/1/2017
1/1/2014
1/1/2010
|
17-3 |
Determining faculty eligibility for off-quarter/semester or for decreases in workload |
1/1/2022
1/1/2021
1/1/2019
1/1/2018
1/1/2017
1/1/2014
|
19-1 |
Termination due to loss of eligibility |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
1/1/2014
1/1/2013
1/1/2012
|
19-1A |
Addendum - Termination due to loss of eligibility: Employee |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
1/1/2014
1/1/2013
1/1/2012
|
19-1B |
Addendum - Termination due to loss of eligibility: Self-pay subscriber |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
1/1/2014
1/1/2013
1/1/2012
|
21-1 |
Exemption from retiree deferral form |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
1/1/2014
1/1/2013
|
26-1 |
Administering PEBB insurance in coordination with Medicare Part D |
1/1/2023
1/1/2022
1/1/2021
4/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2015
1/1/2013
1/1/2012
|
31-1 |
Verifying dependent eligibility before enrollment |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
1/1/2014
1/1/2013
|
31-2 |
Use of premium surcharge tools
|
1/1/2023
1/1/2022
1/1/2020
1/1/2019
1/1/2018
1/1/2016
1/1/2015
4/26/2014
|
33-1 |
Verifying Legal Union's Residency Status |
1/1/2021
1/1/2020
1/1/2019
1/1/2018
4/26/2014 |
36-1 |
Certifying eligibility for a dependent child with a disability who is age 26 or older |
1/1/2023
1/1/2021
1/1/2020
1/1/2019
11/29/2018
1/12/2018
1/1/2015
1/1/2014
1/1/2012
|
37-1 |
Certifying eligibility for an extended dependent child |
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2016
1/1/2014
1/1/2013
12/12/2011
|
45-2 |
Special Open Enrollment (SOE) |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
4/26/2014
1/1/2014
1/1/2013
1/1/2012
|
45-2A |
Addendum - Special open enrollment (SOE) matrix: Summary of permitted election changes |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
4/26/2014
1/1/2014
1/1/2013
1/1/2012
|
56-1 |
Continuation Coverage and retiree insurance coverage reinstatement for subscribers with mental impairment or physical incapacitation
|
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018 |
56-2 |
Continuation Coverage and retiree insurance coverage election period tolling for applicants with mental impairment or physical incapacitation
|
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2018 |
60-1 |
Required appeals related documents when the PEBB Program is hearing an appeal |
1/1/2020
1/1/2019
1/1/2018 |
90-1 |
Allowable mid-year employer group terminations |
1/1/2023
1/1/2021
1/1/2020
1/1/2018
1/1/2017
1/1/2014
|
90-2 |
What authority to employer groups or charter schools need before contracting with the Health Care Authority (HCA) for participation in Public Employees Benefits Board (PEBB) for insurance coverage? |
1/1/2023
1/1/2021
1/1/2020
1/1/2018 |
90-3 |
Determining if an employer group or charter school requesting eligibility standards different from Public Employees Benefits Board (PEBB) program rules shall be approved |
1/1/2023
1/1/2021
1/1/2020
1/1/2018 |
91-1 |
Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018
1/1/2017
1/1/2016
1/1/2015
7/1/2014
4/26/2014
|
91-2 |
Tobacco as it relates to religious or ceremonial use |
1/1/2023
1/1/2022
1/1/2020
1/1/2018
4/26/2014 |
91-3 |
Washington Wellness worksite designation program incentive requirements |
1/1/2023
1/1/2022
1/1/2021
1/1/2020
1/1/2019
1/1/2018 |
93-2 |
PEBB Program payment plans |
1/1/2021
1/1/2020
1/1/2018 |
94-1 |
Accessing PEBB Program salary reduction plan document |
1/1/2023
1/1/2020 |
94-2 |
Accessing PEBB Program wellness plan document |
1/1/2023
1/1/2020 |
94-3 |
Subscriber mistake - Factor test |
1/1/2023 |